Introduction: Extracorporeal membrane oxygenation (ECMO) is a temporary cardiopulmonary support therapy that allows time for organ recovery or for more definitive management to be planned. The use of ECMO in trauma has been increasing, with hospitals now having ECMO teams who can be called to evaluate potential candidates. This study aims to describe the characteristics of trauma patients who were placed on ECMO, what the indication was, and the eventual outcome. Methods: A retrospective analysis of the National Trauma Database from 2020-2022 was performed. All trauma patients who were placed on VA or VV ECMO at any time during their hospital admission were included in the study. Descriptive statistics were used to describe the demographics, injury severity, and indications for ECMO. Mortality and hospital length of stay represented the primary outcome measures. Results: A total of 621 trauma patients received ECMO during their hospitalization. On average patients were 33.1 years old, 81% male, and 75% suffered a blunt injury. The average NISS was 40.3, the overall mortality was 34.3%, and the average hospital length of stay was 31 days, with the average ICU length of stay being 23 days. The average time for a patient being placed on ECMO was 121 hours, with no significant difference in mortality comparing early (24hrs) cannulation. Conclusions: ECMO in trauma patients remains a rapidly evolving area of critical care. Careful patient selection and multidisciplinary coordination is critical for good outcomes. Although current data are limited by heterogeneity and observational design, accumulating reports support ECMO as a viable rescue therapy in trauma, especially among younger patients with reversible pathology. Future prospective studies and trauma-specific ECMO guidelines are needed to define optimal timing, patient selection criteria, and long-term outcomes.
Bressler et al. (Sun,) studied this question.